The predominant acid-base disturbance in a patient with isolated septic shock is which of the following?

• A. Metabolic Acidosis
• B. Respiratory Acidosis
• C. Respiratory Alkalosis
• D. Metabolic Alkalosis

Answer: (A)

In septic shock, the main problem is tissue hypoperfusion leading to anaerobic metabolism and lactic acid buildup. This lactic acidosis lowers bicarbonate and increases the anion gap, producing a metabolic acidosis as the dominant acid-base disturbance. The body typically tries to compensate by increasing ventilation to blow off CO2, so you’ll often see a low PaCO2 as part of respiratory compensation. Respiratory acidosis or metabolic alkalosis aren’t the primary issues in isolated septic shock.